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Dermabrasion – Skin Resurfacing Explained

Dermabrasion is a surgical skin resurfacing procedure in which the outermost layers of the skin are mechanically abraded to treat scars, wrinkles, or pigmentation changes.

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Things worth knowing about "Dermabrasion"

Dermabrasion is a surgical skin resurfacing procedure in which the outermost layers of the skin are mechanically abraded to treat scars, wrinkles, or pigmentation changes.

What is Dermabrasion?

Dermabrasion is a medical and cosmetic procedure in which the outermost layers of the skin are mechanically removed. This is performed using a rotating abrasive instrument or wire brush applied to the skin under local or general anaesthesia. The goal is to smooth uneven skin surfaces and stimulate the natural skin renewal process. The procedure has been used in dermatology and plastic surgery for decades.

Indications

Dermabrasion is used to address a range of skin concerns, including:

Scars from acne or injuries
Fine lines and wrinkles associated with skin ageing
Pigmentation disorders such as age spots or hyperpigmentation
Tattoo removal in certain cases
Actinic keratoses (precancerous skin lesions)
Rhinophyma (bulbous skin thickening of the nose)

How Does Dermabrasion Work?

During dermabrasion, a rotating instrument with an abrasive surface – typically a diamond fraise or wire brush – is passed over the targeted skin area. This removes the epidermis (outermost skin layer) and, depending on the depth of treatment, portions of the dermis (deeper skin layer). This controlled wound stimulus activates the body's natural healing response, prompting the growth of new, smoother skin tissue.

Preparation

Before the procedure, the skin is thoroughly cleaned and disinfected. Depending on the extent of the treatment area, local anaesthesia or general anaesthesia is used. In some cases, the skin is frozen with a cryogenic spray to stabilise and numb the tissue.

Procedure

The procedure itself takes between 30 minutes and several hours depending on the area being treated. After dermabrasion, the skin is covered with special dressings or wound coverings to prevent infection and support healing.

Results and Recovery

Following dermabrasion, the skin is initially red, swollen, and sensitive – similar in appearance to a sunburn. Healing typically takes seven to fourteen days, during which new skin forms. The final result is often not visible until several weeks to months later, once redness has fully subsided.

Redness and swelling in the days immediately following the procedure
Crust formation during the wound healing phase
Temporary increased sensitivity to sunlight
Visible smoothing of the skin after complete healing

Risks and Side Effects

As with any medical procedure, dermabrasion carries certain risks and potential side effects:

Infections caused by bacteria or viruses (e.g., reactivation of the herpes virus)
Scarring, particularly if the abrasion is too deep
Hyper- or hypopigmentation (uneven skin colouring)
Allergic reactions to medications or materials used
Persistent redness (erythema)

People with darker skin tones have a higher risk of pigmentation changes. Thorough medical consultation before the procedure is therefore essential.

Dermabrasion vs. Microdermabrasion

The classic dermabrasion should be distinguished from microdermabrasion, a significantly more superficial and gentler procedure. In microdermabrasion, only the very top cell layers of the epidermis are removed, usually using fine crystals or diamond-tipped wands. This technique is less invasive, requires no anaesthesia, and is suitable for milder skin imperfections and superficial pigmentation changes.

Ideal Candidates

Dermabrasion is ideally suited for individuals with lighter skin types (Fitzpatrick I–III), as the risk of pigmentation disorders is lower in these skin types. The procedure is not recommended for people with active skin conditions (e.g., rosacea flare-ups, active acne), those who have taken isotretinoin within the past 12–18 months, or individuals with a tendency to develop keloid scars.

References

Breuninger H. et al. - Guidelines of the German Dermatological Society on Operative Dermatology (2022).
Freedberg I. M. et al. - Fitzpatrick's Dermatology in General Medicine, 8th Edition, McGraw-Hill (2012).
Hanke C. W., Roenigk R. K. - Dermabrasion. In: Journal of the American Academy of Dermatology, 12(2):345-365 (1985).

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